Ankylosing Spondylitis | First Aid Awareness & Mobility Considerations

Scenario 

During team warm-ups at a community sports league, a participant mentions ongoing stiff back pain that is worse in the mornings and takes a long time to loosen up during the day. While it may seem like a basic muscle strain, some chronic conditions — such as ankylosing spondylitis — can cause recurring stiffness and reduced mobility over time.

What is Ankylosing Spondylitis?

Ankylosing spondylitis (AS) is a form of arthritis that mainly affects the spine. It causes inflammation between the vertebrae and can also involve large joints such as the hips, shoulders and knees. Over time, inflammation can lead to stiffness and reduced mobility. In more advanced cases, new bone can form in the spine which may change posture or movement.

The exact cause is unknown, but family history appears to increase the likelihood. The condition can start in adolescence or early adulthood.

Common Signs & Symptoms

Symptoms can vary and may come and go in “flare-ups.” Common features include:

• Back stiffness or pain (especially in the morning or after rest)

• Pain in the hips, shoulders or large joints

• Fatigue and low energy

• Low-grade fever or reduced appetite during flare-ups

• Reduced range of motion in the spine

Because inflammation can affect other areas of the body, some individuals may also experience:

• Achilles tendon irritation

• Eye irritation

• Digestive discomfort related to inflammation

Why It Matters for First Aid Training

For first aid purposes, ankylosing spondylitis is important to recognize because:

• Sudden immobilization, cold exposure or long seated periods can worsen stiffness

• Individuals may require extra time to move, adjust position or get up from the floor

• Transfers or assisted movement should be done slowly and with consent

• Backpack loads, PPE, heavy equipment or repetitive bending at work may aggravate symptoms

Understanding that stiffness may not always be a muscle injury helps prevent assumptions and allows safer support during recreation, work or training environments.

First Aid & Self-Management Concepts

While diagnosis and treatment are managed by healthcare providers, people often use:

• Heat for stiffness and comfort

• Cold for temporary swelling

• Light activity or stretching to maintain movement (as tolerated)

• Attention to posture at work or during prolonged sitting

Individuals can work with medical teams to determine longer-term management plans.

When to Seek Medical Assessment

Medical assessment is recommended when:

• Stiffness lasts more than a few months

• Symptoms interfere with work, sport or daily routine

• Morning stiffness consistently improves only after prolonged movement

• There is unexplained fatigue, weight loss or chronic joint discomfort

FAQ

Is ankylosing spondylitis curable?
There is no cure, but symptom management and mobility work can support long-term function.

Does it only affect the back?
Mostly the spine, but hips, shoulders and other joints can also be affected.

Is it caused by exercise or sport?
No. Physical activity does not cause AS, although sports may reveal stiffness earlier.

Can teens or young adults develop it?
Yes. Symptoms can begin in adolescence or early adulthood.

Educational Note

This information supports first aid education and awareness. It does not diagnose conditions and does not replace medical evaluation.